=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053551010
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROWLETT ACE INTERNAL MEDICINE LTD LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2009
-----------------------------------------------------
Last Update Date | 03/03/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5700 WOODMONT CT
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-4003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-853-3347
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5700 WOODMONT CT
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-4003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-853-3347
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | HUAN YANG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 469-853-3347
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | L5622
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------